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GPs face a battle to earn share of £228m

GPs face a tough task to get their share of the £228 million for directed enhanced services.

By Ian Cameron

Specifications for the DESs reveal a complicated set of criteria involving aspiration payments and sliding scales of achievement.

These include a requirement for GPs to make one in four hospital appointments via Choose and Book by June this year to get any of the £0.48 per patient available for offering choice.

To qualify for all of the money, GPs must also make 90 per cent of their referrals between September and February 2007 using electronic and manual Choose and Book systems.

For the access enhanced service, GPs will be assessed via a patient survey on whether they offer a GP consultation in 48 hours, booking in advance, ease of phone access and a consultation with the GP of the patient's choice.

Upfront payments worth £0.69 per patient of the £2.06 total rely on written plans showing how the first three elements will be met and a promise to continue to take part in monthly PCT access surveys.

Achievement pay worth £1.37 per patient is dependent on the outcome of the new patient survey, with a sliding scale dictating the level of payment.

Practices must have offered 90 per cent of patients access within two working days and advance booking, and 80 per cent telephone access and a practitioner of choice, to get all of the achievement pay.

The patient survey will also be used to assess the second part of the Choice and Booking DES, on whether GPs have offered choice during the consultation.

GPs will get £0.24 for a written statement promising to offer choice and £0.24 if 60 per cent of patients surveyed recall a conversation about a choice during their consultation.

Up to £1.33 per patient is available for implementing Connecting for Health IT plans, including showing a readiness to work with a shared electronic record.

But the money may not be paid until the end of 2007 or later in some cases because of local variations in the speed of development of the required systems.

Dr Hamish Meldrum, GPC chair, said the specifications for the DESs deliberately mirrored the QOF payment structure.

He said: 'We were very anxious to keep away from ''all or nothing'' targets and allow people to get on the ladder.'

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